blue98ls1 Posted May 16, 2019 Report Share Posted May 16, 2019 From what I understand from the doctors, he will be moved to an actual hospital bed once he leaves ICU.. Doesn't sound like this will be super soon yet. From there he will go to a place to get therapy to rebuild his muscles and try to get back to normal. He is very strong willed though so its hard to say what will happen once he wakes up fully. He was powering through all of the sedation yesterday and more awake. The last few days he had a lot of agitation. Yesterday he was more relaxed and though he was still very much out of it, he was responding to questions with a nod without becoming super anxious. Quote Link to comment Share on other sites More sharing options...
excell Posted May 17, 2019 Author Report Share Posted May 17, 2019 Kicking the can again. Trach tomorrow. He's really starting to look around/wake up/be sort of present -- even acknowledged me via video call today. Really need to get his face available again. Quote Link to comment Share on other sites More sharing options...
zeitgeist57 Posted May 17, 2019 Report Share Posted May 17, 2019 Hoping that he maintains progress tomorrow! Quote Link to comment Share on other sites More sharing options...
RedRocket1647545505 Posted May 17, 2019 Report Share Posted May 17, 2019 From what I understand from the doctors, he will be moved to an actual hospital bed once he leaves ICU.. Doesn't sound like this will be super soon yet. From there he will go to a place to get therapy to rebuild his muscles and try to get back to normal. He is very strong willed though so its hard to say what will happen once he wakes up fully. He was powering through all of the sedation yesterday and more awake. The last few days he had a lot of agitation. Yesterday he was more relaxed and though he was still very much out of it, he was responding to questions with a nod without becoming super anxious. Typical progression from ICU to discharge is incrementally decreasing levels of care; there are typically 3 levels in a hospital. Once he's trach'd, he will most likely go to a step-down/intermediate unit, especially if he is still vent-dependent. This takes into account that he's off of everything else that might hold him in an ICU, such as IV meds to control his blood pressure, vital signs in general, oxygen requirements, certain sedating/pain meds, and how likely he is to regress back towards needing intensive care. Once in a step-down unit, they will continue to work towards liberating him from the vent. They will start stripping away ventilator support and start making him do more of the work, with the goal that he will eventually do most of the breathing on his own. That's the great thing about trachs. A lot of families get scared by them but they really are a great safety net to have during the rehab process. If you want to see how he breathes on his own, you just disconnect him from the vent. If he fails, you just pop him back on the vent. With the tube in his mouth, if you want to see how he breathes on his own, you have to take the whole tube out. If he fails, then they have to try to emergently put it back in, which doesn't always go as planned. Physical/Occupational therapy will get more intense. I assume they will place a PEG tube in his stomach (so he can get some nutrition) while he's getting a trach, so at some point Speech therapy will step in to evaluate his ability to safely swallow in hopes that he can start eating some actual food again instead of that yellow bag of shit we feed patients. They will continue to tweak his oral meds to help with any issues he's having. Once he's off the vent, they will place him on a trach-mask or a T-piece to deliver some supplemental humidified oxygen to him. Once his oxygen requirements are low enough (and if he's not on any IV meds that require an Intermediate level of care), they will transfer him to 'The Floor'/MedSurg, which is typically the lowest acuity unit in a hospital. Once on The Floor, he will hopefully be up and moving around more, gaining more independence and plans will most likely be made via a Social Worker/Case Manager for placement in a rehab facility (Probably Dodd Hall...). The best thing for him at this point, mentally, is to get out of the ICU. People get delirious as fuck with long stays in ICUs (is actually called ICU delirium). They get this 1000yd stare to them and it can be a PITA to manage, really throwing a wrench in their progress. The best way to fix it is to get him out of the hospital and back to a normal life. Hopefully that paints somewhat of a picture of what you are probably going to encounter on his road to recovery. It's a marathon, not a sprint. Try to hang in there and don't forget to take care of yourselves as well during this time. He's really going to lean on you guys when he gets home, at least for awhile. Sitting in an ICU waiting room all day staring at the walls really doesn't do anyone any good. He's in the best hands right now. Have faith in the system. Quote Link to comment Share on other sites More sharing options...
excell Posted May 17, 2019 Author Report Share Posted May 17, 2019 No updates yet today. Typical progression from ICU to discharge is incrementally decreasing levels of care; there are typically 3 levels in a hospital. Once he's trach'd, he will most likely go to a step-down/intermediate unit, especially if he is still vent-dependent. This takes into account that he's off of everything else that might hold him in an ICU, such as IV meds to control his blood pressure, vital signs in general, oxygen requirements, certain sedating/pain meds, and how likely he is to regress back towards needing intensive care. Once in a step-down unit, they will continue to work towards liberating him from the vent. They will start stripping away ventilator support and start making him do more of the work, with the goal that he will eventually do most of the breathing on his own. That's the great thing about trachs. A lot of families get scared by them but they really are a great safety net to have during the rehab process. If you want to see how he breathes on his own, you just disconnect him from the vent. If he fails, you just pop him back on the vent. With the tube in his mouth, if you want to see how he breathes on his own, you have to take the whole tube out. If he fails, then they have to try to emergently put it back in, which doesn't always go as planned. Physical/Occupational therapy will get more intense. I assume they will place a PEG tube in his stomach (so he can get some nutrition) while he's getting a trach, so at some point Speech therapy will step in to evaluate his ability to safely swallow in hopes that he can start eating some actual food again instead of that yellow bag of shit we feed patients. They will continue to tweak his oral meds to help with any issues he's having. Once he's off the vent, they will place him on a trach-mask or a T-piece to deliver some supplemental humidified oxygen to him. Once his oxygen requirements are low enough (and if he's not on any IV meds that require an Intermediate level of care), they will transfer him to 'The Floor'/MedSurg, which is typically the lowest acuity unit in a hospital. Once on The Floor, he will hopefully be up and moving around more, gaining more independence and plans will most likely be made via a Social Worker/Case Manager for placement in a rehab facility (Probably Dodd Hall...). The best thing for him at this point, mentally, is to get out of the ICU. People get delirious as fuck with long stays in ICUs (is actually called ICU delirium). They get this 1000yd stare to them and it can be a PITA to manage, really throwing a wrench in their progress. The best way to fix it is to get him out of the hospital and back to a normal life. Hopefully that paints somewhat of a picture of what you are probably going to encounter on his road to recovery. It's a marathon, not a sprint. Try to hang in there and don't forget to take care of yourselves as well during this time. He's really going to lean on you guys when he gets home, at least for awhile. Sitting in an ICU waiting room all day staring at the walls really doesn't do anyone any good. He's in the best hands right now. Have faith in the system. This was INSANELY helpful -- thank you so much for your perspective. No one has explained any of this to us in this level of detail. They have been mentioning he was getting delirious, but it seems to us that he might be doing a decent job of managing his anxiety a bit on his own the last couple days. We are hoping the trach helps this more, since he will have his face back. They already have the PEG tube in. I can't thank you enough for this information. Quote Link to comment Share on other sites More sharing options...
RedRocket1647545505 Posted May 17, 2019 Report Share Posted May 17, 2019 (edited) No updates yet today. This was INSANELY helpful -- thank you so much for your perspective. No one has explained any of this to us in this level of detail. They have been mentioning he was getting delirious, but it seems to us that he might be doing a decent job of managing his anxiety a bit on his own the last couple days. We are hoping the trach helps this more, since he will have his face back. They already have the PEG tube in. I can't thank you enough for this information. The trach will help with the anxiety of constantly being gagged by the ET Tube. It's easy for us to say, "Calm Down", but imagine having something tripping your gag reflex while you're breathing through a straw and trying to ignore it... The trach, however, can also induce some of its own anxiety, though not nearly as bad. When they initially put it in, there will be some irritation to his airway. Expect blood and drainage/secretions from around it; this is normal. The irritation will cause him to cough constantly until his airway gets used to the foreign body that's in it. Try not to get bothered by the sound. You'll know what I mean. He will be able to breathe easier, though. The trach is typically a little bigger in diameter and about 1/4 the length of the ETT. Bigger hole + shorter length = less resistance to flow (Ohm's law, if you care). And no problem on the info. Let me know if you guys have any questions about anything. I'll help in any way that I can. Edited May 17, 2019 by RedRocket Quote Link to comment Share on other sites More sharing options...
excell Posted May 17, 2019 Author Report Share Posted May 17, 2019 Sigh. Mixed news today. The ENT still doesn't feel he's ready for the trach, so it's been pushed to Monday. However, they think he may pass breathing trials so they're gonna try those this weekend. If he passes, the tube comes out and no trach. Beats the fuck out of me how it could be one extreme or another. Quote Link to comment Share on other sites More sharing options...
kirks5oh Posted May 19, 2019 Report Share Posted May 19, 2019 Been following this thread, lurking. Thoughts and prayers sent. Thanks for all the updates Quote Link to comment Share on other sites More sharing options...
Not Brian Posted May 19, 2019 Report Share Posted May 19, 2019 Let us know when he can have visitors mayne Quote Link to comment Share on other sites More sharing options...
excell Posted May 19, 2019 Author Report Share Posted May 19, 2019 Let us know when he can have visitors mayne Will do. Should know more tomorrow/Monday on his progression. Quote Link to comment Share on other sites More sharing options...
excell Posted May 20, 2019 Author Report Share Posted May 20, 2019 No big changes today. He's really showing signs of improvement in his ability to respond to questions, etc and his overall vitals. Hoping for a breathing test and maybe we can skip the trach? Frustrating. Quote Link to comment Share on other sites More sharing options...
excell Posted May 20, 2019 Author Report Share Posted May 20, 2019 (edited) OK, well. Anthony apparently snapped out of things late last night and decided on his own he'd had enough of this shit and ripped out his own breathing tube. So, he's not on any sedation meds anymore and breathing on his own which means no trach at this time either. So here's to some good news! Edited May 20, 2019 by excell Quote Link to comment Share on other sites More sharing options...
Cordell Posted May 20, 2019 Report Share Posted May 20, 2019 Now that sounds like him. :thumbup: Quote Link to comment Share on other sites More sharing options...
excell Posted May 20, 2019 Author Report Share Posted May 20, 2019 Now that sounds like him. :thumbup: Yep. He's already out of bed, sitting in a chair and eating a little bit. Quote Link to comment Share on other sites More sharing options...
Cordell Posted May 20, 2019 Report Share Posted May 20, 2019 Yep. He's already out of bed, sitting in a chair and eating a little bit. Awesome. Quote Link to comment Share on other sites More sharing options...
zeitgeist57 Posted May 20, 2019 Report Share Posted May 20, 2019 WTF?!?!?! That's an awesome development! April 28th - bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden May 20th - punched an orderly and left his room. Quote Link to comment Share on other sites More sharing options...
BBQdDude Posted May 20, 2019 Report Share Posted May 20, 2019 Most awesome news!!!!! Quote Link to comment Share on other sites More sharing options...
Hwilli1647545487 Posted May 20, 2019 Report Share Posted May 20, 2019 WTF?!?!?! That's an awesome development! April 28th - bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden May 20th - punched an orderly and left his room. Lol Quote Link to comment Share on other sites More sharing options...
Orion Posted May 20, 2019 Report Share Posted May 20, 2019 Thats great news, and definitely sounds like Ant. The trach will help with the anxiety of constantly being gagged by the ET Tube. It's easy for us to say, "Calm Down", but imagine having something tripping your gag reflex while you're breathing through a straw and trying to ignore it... Trust me, Ant doesn't have a gag reflex. I know from experience. :gay2: Quote Link to comment Share on other sites More sharing options...
Rally Pat Posted May 20, 2019 Report Share Posted May 20, 2019 OK, well. Anthony apparently snapped out of things late last night and decided on his own he'd had enough of this shit and ripped out his own breathing tube. So, he's not on any sedation meds anymore and breathing on his own which means no trach at this time either. So here's to some good news! Thats the most Anthony way things could have gone lol Quote Link to comment Share on other sites More sharing options...
excell Posted May 20, 2019 Author Report Share Posted May 20, 2019 WTF?!?!?! That's an awesome development! April 28th - bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden May 20th - punched an orderly and left his room. Pretty much. I just talked to him via video, he is SUPER groggy and on a healthy dose of Dilauded but he's lucid. He can whisper talk and is nibbling food. He laughed when I asked him if he just got sick of this shit. He does not remember pulling the tube himself, but sure looks relieved. Quote Link to comment Share on other sites More sharing options...
Forrest Gump 9 Posted May 20, 2019 Report Share Posted May 20, 2019 WTF?!?!?! That's an awesome development! April 28th - bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden bedridden May 20th - punched an orderly and left his room. Can’t complaint with that awesome explanation Quote Link to comment Share on other sites More sharing options...
Tractor Posted May 20, 2019 Report Share Posted May 20, 2019 Thats great news! Quote Link to comment Share on other sites More sharing options...
wagner Posted May 20, 2019 Report Share Posted May 20, 2019 OK, well. Anthony apparently snapped out of things late last night and decided on his own he'd had enough of this shit and ripped out his own breathing tube. So, he's not on any sedation meds anymore and breathing on his own which means no trach at this time either. So here's to some good news! Yeah, that sounds about right Quote Link to comment Share on other sites More sharing options...
TimTaylor751647545500 Posted May 20, 2019 Report Share Posted May 20, 2019 Awesome news! Quote Link to comment Share on other sites More sharing options...
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